Pediatrics ATI Practice Exam!! Type A

A nurse is caring for a preschooler who has neutropenia. Which of the following statements should the nurse make to the child's guardians? "Monitor your child's temperature at least once a week." "Going to the movie theater might help improve your child's mood." "Avoid using your child's daycare center." "Schedule your child's varicella immunization."

"Avoid using your child's daycare center."

A nurse is providing teaching to the parent of a school-age child who has a new prescription for oral nystatin for the treatment of oral candidiasis. Which of the following instructions should the nurse include? "Shake the medication prior to administration." "Provide the medication through a straw." "Rinse the child's mouth with water immediately after giving the medication." "Mix the medication with applesauce if the child dislikes the taste."

"Shake the medication prior to administration."

A charge nurse in an emergency department is preparing an in-service for a group of newly licensed nurses on the clinical manifestations of child maltreatment. Which of the following clinical manifestations should the charge nurse include as a suggestive of potential physical abuse? -recurrent UTI-growth failure -lack of subcutaneous fat -symmetric burns of the lower extremities

-symmetric burns of the lower extremities

A nurse is reviewing the dietary choices of an adolescent who has iron deficiency anemia. The nurse should identify that which of the following menu items has the highest amount of iron?

1/2 cup of raisins

A nurse is caring for a school age child who is in Bucks traction following a leg fracture 24 hrs hours. Which of the following actions should the nurse take? A) Assess peripheral pulses once every 4hrs. B) Buck's traction is a type of skin traction that can be used to immobilize extremities prior to surgery. C) The nurse should provide frequent neurovascular checks at least every 4 hr after the first 24 hr of placement in Buck's traction. D) The nurse should monitor and report signs of neurovascular impairment in the extremities such as cyanosis, edema, pain, absent pulses, and tingling.

A) Assess peripheral pulses once every 4hrs.

A nurse on a pediatric unit is caring for a toddler. Medical history: Hemophilia A. What is anticipated vs contraindicated?

Potential Provider's Prescription Anticipated: Administer factor VIII. Apply ice packs to the affected joints. Administer morphine PRN pain. Elevate the affected joints Contraindication Perform passive range-of-motion (ROM) exercises during the first 12 hr following injury.

A nurse is assessing a 6-month-old during a well check up. Which of the findings should be reported to the provider? Presence of a central incisor tooth Presence of strabismus Presence of an open anterior fontanel Presence of external cerumen

Presence of strabismus

The nurse is caring for a client receiving intravenous fluids through a peripheral intravenous catheter (IV). On rounds, the nurse notes that the client's IV site and arm are swollen and cool to the touch. Based on these assessment findings, what will the nurse do next? Occlude the IV tubing Turn off the IV pump Remove the tape securing the catheter Apply pressure over the catheter insertion site

Turn off the IV pump Occlude the IV tubing Remove the tape securing the catheter Apply pressure over the catheter insertion site

A nurse is caring for a 1 month old infant who is breastfeeding and requires a heel stick. Which of the following actions should the nurse take to minimize that infant's pain? a. Use a manual lancet to obtain the heel blood sample b. apply an ice pack to the infant's heel prior to obtaining the sample c. allow the mother to breastfeed while the sample is being obtained d. apply a topical lidocaine cream prior to obtaining the sample

c. allow the mother to breastfeed while the sample is being obtained

A nurse is discussing organ donation with the parents of a school age child who has sustained brain death due to a bicycle crash. Which of the following actions should the nurse take first? a. inform the parents that written consent is required prior to organ donation b. provide written information to the parents about organ donation c. ask the provider to explain misconceptions of organ donation to the parents. d. explore the parents feelings and wishes regarding organ donation

d. explore the parents feelings and wishes regarding organ donation

A nurse is providing anticipatory guidance to the parent of a toddler. Which of the following expected behavior characteristics of toddlers should the nurse include? a. controls impulsive feelings b. understands right from wrong c. easily separates from parents for long periods of time d. expresses likes and dislikes

d. expresses likes and dislikes

A nurse is teaching the parent of a preschooler about ways to prevent acute asthma attacks. Which of the following statements by the parent indicates an understanding of the teaching? a. I will use a humidifier in my child's room at night b. I will give my child a cough suppressant every 6 hours if he ha a cough c. I should avoid using a wet mop on the floors when I am cleaning d. I should keep my child indoors when I mow the yard

d. I should keep my child indoors when I mow the yard

A nurse is caring for a 12-month-old toddler who is being hospitalized. Which of the following actions should the nurse plan to take? A) Place a plastic cover over the toddler's pillow at bedtime. B; Encourage the toddler's parent to provide latex balloons for the child to play with. C; offer the toddler raising for a snack. D; Secure the safety harness when the toddler is sitting in a high chair

D; Secure the safety harness when the toddler is sitting in a high chair

Creating a plan of care for an infant who has an epidural hematoma with a skull fracture. Appropriate action to include? Implement seizure precautions for the infant. Perform a neurological assessment every 4 hr. Suction the infant's nares to remove secretions. Position the infant side-lying with their head at a 0° to 5° angle.

Implement seizure precautions for the infant.

A nurse is admitting a school-age child who has pertussis. Which of the following actions should the nurse take Place the child in a room with positive-pressure airflow. Place the child in a room with negative-pressure airflow. Initiate contact precautions for the child. Initiate droplet precautions for the child.

Initiate droplet precautions for the child.

A nurse is assessing a 4-year-old child at a well-child visit. Which of the following developmental milestones should the nurse expect to observe Identifies right from left hand Uses a utensil to spread butter Cuts a shape using scissors Draws a stick figure with seven body parts

Cuts a shape using scissors

A charge nurse is preparing a room assignment for a school-age child. Which of the following is the most important consideration when planning a room assignment? Length of stay Treatment schedule Disease process Self-care ability

Disease process

A nurse is reviewing the medical record of a school-age child who is 2 days postoperative following an open repair and casting of a fracture in the right arm. Which of the following findings should the nurse identify as an indication of a potential postoperative complication? a. increased erythrocyte sedimentation rate b. apical pulse 92/min c. respiratory rate 24/min d. taking an oral analgesic twice daily

a. increased erythrocyte sedimentation rate

A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the priority action by the nurse? Elevate the head of the child's bed. Insert a large bore IV catheter for the child. Determine the allergen that caused the child's reaction. Administer epinephrine IM to the child.

Administer epinephrine IM to the child.

A nurse is caring for a preschooler who was recently admitted to a pediatric unit. Nurses' Notes The preschooler's guardians report that their child had a gastrointestinal illness with some vomiting and diarrhea about 1 week ago. Their child started to feel better. However, within the last 2 days, they noticed several small bruises that appeared on their child's arms and legs. Additionally, the guardians report the child is lethargic. The nurse is reviewing the information in the child's electronic medical record (EMR). For each EMR finding, click to specify if the finding is consistent with nephrotic syndrome, acute poststreptococcal glomerulonephritis, or hemolytic uremic syndrome. Each finding may support more than one disease process.

Nephrotic Syndrome- BP, Cholesterol APG- temp, BUN, BP HUS- temp, BUN, platelet, BP

Nurse creating POC (plan of care) for preschooler with Wilms' tumor and scheduled for surgery. Which interventions should the nurse include? Avoid palpating the abdomen when bathing the child before surgery. Refrain from auscultating the child's bowel sounds during the postoperative assessment. Encourage the child to play with other children on the unit prior to surgery. Explain to the child that their pain will be managed after the surgery.

Avoid palpating the abdomen when bathing the child before surgery.

A nurse is caring for an adolescent who received a kidney transplant. Which of the following findings should the nurse identify as an indication the adolescent is rejecting the kidney? A. negative leukocyte esterase B. Increased creatinine levels C. negative urine protein D. urine output 40mL/hr

B. Increased creatinine levels

A nurse is providing discharge teaching to the parent of an 18 mo old toddler who has dehydration as a result of acute diarrhea. Which of the following statements by the parent indicates an understanding of the teaching? A) I will offer my child small amounts of fruit juice frequently B) I will avoid giving my child solid foods until his diarrhea has stopped C) I will monitor my child's number of wet diapers D)I will give my child polyethylene glycol daily for 7 days

C) I will monitor my child's number of wet diapers

Graphic Record Temperature 37.5° C (99.5° F) Heart rate 70/min Respiratory rate 30/min Birth weight 3.2 kg (7 lb) Current weight 5.9 (13 lb) Nurses' Notes 3 episodes of vomiting 6 wet diapers in 24 hr Consumed 3 oz concentrated formula every 3 hr Medication Administration Record Digoxin 0.5 mcg PO Q12H Furosemide 20 mg PO Q12H Episodes of vomiting Formula consumption Weight Temperature

Episodes of vomiting

The nurse has reviewed the child's nurses notes, assessment, vital signs, providers prescriptions and laboratory results for the 0800 one month ago visit Nurses' Notes​ 2 months ago: The toddler is here for their well-child visit and is accompanied by a parent. Toddler is active, alert, and walking without assistance. The parent reports moving to an older urban house, which is currently being renovated, about 6 months ago. Parent reports having difficulty getting the toddler to eat and states, "they are a picky eater." Parent reports they have not started toilet training. The parent expresses concern that the child seems less active recently and gets tired more quickly. Ferrous sulfate elixir 34 mg PO three times per day Succimer capsule 100 mg PO every 8 hr for 5 days Restrict oral fluids. Limit intake of calcium-rich foods. Check blood lead level in 1 week. Consult Social Services. Consult a dietitian.

Ferrous sulfate elixir 34 mg PO three times per day - anticipated Succimer capsule 100 mg PO every 8 hr for 5 days - anticipated Restrict oral fluids - contraindicated Limit intake of calcium-rich foods.- contraindicated Check blood lead level in 1 week - contraindicated Consult Social Services - anticipated Consult a Dietician - anticipated

Nurse in health department is caring for emancipated adolescent with STI and unaccompanied by guardian. Which actions should the nurse take? Have the adolescent sign a consent form for treatment. Instruct the adolescent to return with a guardian. Obtain consent from the adolescent's guardian over the phone Treat the adolescent without a consent form

Have the adolescent sign a consent form for treatment.

A nurse is receiving change of shift report for four children. Which of the following children should the nurse assess first? a. a toddler who has a concussion and an episode of forceful vomiting b. an adolescent who has infective endocarditis and reports having a headache c. an adolescent who was placed into halo traction 1 hr ago and reports pain as 6 on a scale of 0-10 d. a school age child who has acute glomerulonephritis and brown-colored urine

a. a toddler who has a concussion and an episode of forceful vomiting

A nurse is reviewing the laboratory report of a school-age child who is experiencing fatigue. Which of the following findings should the nurse recognize as an indication of anemia? a. hematocrit 28% b. hemoglobin 13.5 g/dl c. WBC 8,000 d. platelets 250,000

a. hematocrit 28%

Provider Prescriptions​Tuberculin skin test (TST)Measles, mumps, and rubella (MMR) vaccine Inactivated influenza vaccine Diphtheria, tetanus, and pertussis (DTaP) vaccine Graphic Record Respiratory rate 24/min Heart rate 115/min Temperature 36.9° C (98.4° F) History and Physical​Age 15 months Height 71.1 cm (28 in)Allergies Neomycin (anaphylactic reaction)Caregiver reports rhinitis with clear nasal drainage for 2 days Occasional nonproductive cough for 2 days History of asthma History and Physical​Age 15 months Height 71.1 cm (28 in)Allergies Neomycin (anaphylactic reaction)Caregiver reports rhinitis with clear nasal drainage for 2 days Occasional nonproductive cough for 2 days History of asthma Withhold the measles, mumps, and rubella (MMR) vaccine. Withhold the diphtheria, tetanus, and pertussis (DTaP) vaccine. Withhold the influenza vaccine. Withhold the tuberculin skin test (TST).

Withhold the measles, mumps, and rubella (MMR) vaccine.

A nurse is caring for a preschooler whose father is going home for a few hours while another relative stays with the child. Which of the following statements should the nurse make to explain to the child when their father will return?

Your daddy will be back after you eat

A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should teach the parent to apply which of the following to the affected area? Antibiotic ointment Zinc oxide Talcum Powder Antiseptic solution

Zinc oxide

A nurse is teaching a group of parents about infectious mononucleosis. Which of the following statements by a parent indicates an understanding the teaching? a. "Mononucleosis is caused by an infection with the Epstein-Barr virus." b. "Mononucleosis is a bacterial infection requiring 14 days of antibiotics." c. "A monospot is a throat culture used to diagnosis mononucleosis." d. "Children who get mononucleosis will need to refrain form sports for 6 months."

a. "Mononucleosis is caused by an infection with the Epstein-Barr virus."

A nurse is providing discharge teaching to the parents of a 3-month-old infant following a cheiloplasty. Which of the following instructions should the nurse include? - apply a thin layer of antibiotic ointment on your baby's suture line daily for the next 3 days - clean your baby's sutures daily with a mixture of chlorhexidine and water - inspect your baby's tongue for white patches using a tongue depressor every 8 hours - expect your baby to swallow more than usual for the next few days

- apply a thin layer of antibiotic ointment on your baby's suture line daily for the next 3 days

A nurse is preparing an adolescent client for a lumbar puncture. Which of the following instructions should the nurse provide to the adolescent? Place a cardiac monitor on the adolescent prior to the procedure. Apply topical analgesic cream to the site 1 hr prior to the procedure. Keep the adolescent in a semi-Fowler's position for 4 hr following the procedure. Restrict fluids for 2 hr following the procedure

Apply topical analgesic cream to the site 1 hr prior to the procedure.

A nurse is assessing a 6-year-old child immediately following surgery for a perforated appendix. Which of the following findings should the nurse expect? Purulent drainage from the NG tube Hypoactive bowel sounds Passage of dark red stool Urine output of 20mL per hour

Hypoactive bowel sounds

The nurse has reviewed the child's nurses notes, assessment, vital signs, providers prescriptions and laboratory results for today's visit. Nurses' Notes​ 2 months ago: The toddler is here for their well-child visit and is accompanied by a parent. Toddler is active, alert, and walking without assistance. The parent reports moving to an older urban house, which is currently being renovated, about 6 months ago. Parent reports having difficulty getting the toddler to eat and states, "they are a picky eater." Parent reports they have not started toilet training. The parent expresses concern that the child seems less active recently and gets tired more quickly. Which of the following conditions are improving since the child's visit 1 month ago? Select 4 of the following conditions. Hearing Kidney function Nutritional status Lead level Exposure to lead Anemia

Kidney function Nutritional status Lead level Exposure to lead

Increased sodium level Decreased urine specific gravity Mental confusion Weak peripheral pulses

Mental confusion

A nurse is providing teaching about play activities for social development to the guardians of a preschooler? Playing pat-a-cake Using a push-pull toy Creating a scrapbook Playing dress-up

Playing dress-up

A community health nurse is assessing an 18-month-old toddler in a community day care. Which of the following findings should the nurse identify as a potential indication of physical neglect?

Poor physical hygiene

Nurses' Notes2 months ago: The toddler is here for their well-child visit and is accompanied by a parent. Toddler is active, alert, and walking without assistance. The parent reports moving to an older urban house, which is currently being renovated, about 6 months ago. Parent reports having difficulty getting the toddler to eat and states, "they are a picky eater." Parent reports they have not started toilet training. The parent expresses concern that the child seems less active recently and gets tired more quickly. Drag words from the choices below to fill in each blank in the following sentence. The child is at risk for developing Target 1and Target 2. Word Choices bulging fontanel abdominal obstruction intellectual deficits acute lymphoblastic leukemia decreased kidney function

The child is at risk for developing intellectual deficits and decreased kidney function.

A nurse is creating a plan of care for a school-age child who has heart disease and has developed heart failure. Which of the following interventions should the nurse include in the plan? a. provide small, frequent meals for the child b. schedule time in the play room for the child c. weigh the child weekly d. maintain the child in a supine position

a. provide small, frequent meals for the child

A nurse is providing teaching to the parents of a preschooler who has heart failure and a new prescription for digoxin twice daily. Which of the following instructions should the nurse include in the teaching? a. "Use a kitchen teaspoon to measure the medication." b. "Brush the child's teeth after giving the medication." c. "double the next dose if the child misses a dose." d. "repeat the dose if the child vomits."

b. "Brush the child's teeth after giving the medication."

A nurse is providing teaching to the family of a school-age child who has juvenile idiopathic arthrisis. Which of the following instructions should the nurse include in the teaching a. "limit movement of the child's large joints" b. "encourage the child to perform independent self-care." c. "provide the child with a soft mattress for sleeping." d. "schedule a 2 hour daily nap for the child in the afternoon."

b. "encourage the child to perform independent self-care."

A nurse is caring for a 10 year old child following a head injury. Which of the following findings should the nurse identify as an indication that the child is developing diabetes insipidus? a. urine specific gravity 1.045 b. sodium 155 mEq/L c. blood glucose 45 mg/dL d. urine output 35 mL/hr

b. sodium 155 mEq/L (high sodium level)

A nurse in an urgent care clinic is assessing an adolescent who has an upper respiratory tract infection. Which of the following findings should the nurse identify as a manifestation of pertussis? a) Inflamed throat with exudate b) Purulent eye drainage c) Dry, hacking cough d) Koplik spots on buccal mucosa

c) Dry, hacking cough

A nurse is assessing an 8-year-old child who has early indications of shock. After establishing an airway and stabilizing the child's respirations, which of the following actions should the nurse take next? a. insert an indwelling urinary catheter b. measure weight and height c. initiate IV access d. maintain ECG monitoring

c. initiate IV access

Click to highlight the findings that require follow-up. To deselect a finding, click on the finding again. Mucous membranes are pale pink and moist. Heart rate increases during inspiration and decreases during expiration. S1, S2, and S3 are heard upon auscultation. Abdomen is soft and nondistended. Bowel sounds are present. Noted genu valgum when child walks. Babinski reflex is negative. Parent reports moving to an older urban house, which is being renovated, about 6 months ago. Parent reports having difficulty getting the child to eat and states, "they are a picky eater." The parent expresses concern that the child seems less active recently and gets tired more quickly.

Mucous membranes are pale pink and moist. Parent reports moving to an older urban house, which is being renovated, about 6 months ago. The parent expresses concern that the child seems less active recently and gets tired more quickly.

The nurse has reviewed the provider prescriptions for the 0900, 1 month ago visit. Nurses' Notes​ The toddler is here for their well-child visit and is accompanied by a parent. Toddler is active, alert, and walking without assistance. The parent reports moving to an older urban house, which is currently being renovated, about 6 months ago. Parent reports having difficulty getting the toddler to eat and states, "they are a picky eater." Parent reports they have not started toilet training. Offer orange juice to the child when giving ferrous sulfate. Give the ferrous sulfate with meals. Notify the provider if the child's stools become black. Open the succimer capsule and sprinkle on 1 tsp of applesauce. Monitor the number of wet diapers. Use a wet cloth to dust when house cleaning. Prevent the child from playing in soil near the house. Use a straw to administer the ferrous sulfate.

Offer orange juice to the child when giving ferrous sulfate. Open the succimer capsule and sprinkle on 1 tsp of applesauce. Monitor the number of wet diapers. Use a wet cloth to dust when house cleaning. Prevent the child from playing in soil near the house. Use a straw to administer the ferrous sulfate.

Nurses' Notes​ 2 months ago: The toddler is here for their well-child visit and is accompanied by a parent. Toddler is active, alert, and walking without assistance. The parent reports moving to an older urban house, which is currently being renovated, about 6 months ago. Parent reports having difficulty getting the toddler to eat and states, "they are a picky eater." Parent reports they have not started toilet training. The parent expresses concern that the child seems less active recently and gets tired more quickly. ​

The nurse should first address the child's blood lead level , followed by the child's hemoglobin

A nurse on a pediatric unit is caring for a school-age child. Exhibit 1 Exhibit 2 Exhibit 3 Exhibit 4 Diagnostic Results CBC: Hemoglobin 8.0 g/dL (10 to 15.5 g/dL)Hematocrit 28% (32% to 44%)RBC count 4.2 million/mm3 (4 to 5.5 million/mm3)WBC count 12,000/mm3 (5,000 to 10,000/mm3)Platelets 350,000/mm3 (150,000 to 400,000/mm3)Reticulocyte count 3% (0.5% to 2%)A nurse on a pediatric unit is caring for a school-age child.

The nurse should first address the child's oxygen saturation followed by the child's pain

A nurse is assessing an adolescent who received a sodium polystyrene sulfonate enema. Which of the following findings indicates effectiveness of the medication? a. reports an absence of nausea and vomiting b. reports experiencing an onset of loose stools within 15 minutes of administration c. serum potassium level 4.1 mEq/L d. blood pressure 86/52 mm Hg

c. serum potassium level 4.1 mEq/L

A nurse is caring for a preschooler who is scheduled for hydrotherapy treatment for wound debridement following a burn injury. Which of the following actions should the nurse take prior to the procedure?

Administer an analgesic to the child

A nurse in a pediatric emergency department is planning care for an adolescent. Exhibit 1 Exhibit 2 Exhibit 3 Nurses' Notes 2245: Adolescent arrived via stretcher by Emergency Medical Transport (EMT) following a motor-vehicle crash.EMT personnel report: Client was found conscious at the scene inside of the vehicle with airbag deployed, wearing a seat belt. Vital signs: heart rate: 94/min, respiratory rate 20/min, blood pressure 100/60 mm Hg 18-gauge peripheral IV inserted in left antecubital. Guardians contacted and report the child has no medical conditions.2300:Adolescent reports sharp pain in chest. Rates pain as 6 on a scale of 0 to 10. Respirations fast and shallow. Diminished breath sounds in left lung. S1 and S2 regular and rapid. Apply Supplemental Oxygen Prepare for chest tube Place adolescent in supine position Obtain consent for a paracentesis Administer a levalbuterol inhaler

Apply Supplemental Oxygen Prepare for chest tube

A nurse is planning an educational program for school-age children and their parents about bicycle safety. Which of the following information should the nurse plan to include? The child should ride their bike 2 feet to the side of other bike riders. The child should be able to stand on the balls of their feet when sitting on the bike. The child should wear dark-colored clothing with a fluorescent stripe when riding at night. The child should ride the bike facing traffic when it is necessary to ride in the street.

The child should be able to stand on the balls of their feet when sitting on the bike.

A nurse is caring for a school-age child who is receiving chemotherapy and is severely immunocompromised. Which of the following actions should the nurse take? Use surgical asepsis when providing routine care for the child. Administer the measles, mumps, and rubella (MMR) vaccine to the child. Screen the child's visitors for indications of infection. Infuse packed RBCs.

Screen the child's visitors for indications of infection.

A nurse in an emergency department is caring for a school age child who has epiglottitis. Which of the following actions should the nurse take? a. obtain a throat culture form the child b. monitor the child's oxygen saturation c. put a warm mist humidifier in the child's room d. place the child in the supine position

b. monitor the child's oxygen saturation